Provider Demographics
NPI:1174310940
Name:HEARTS AT HOME LLC
Entity type:Organization
Organization Name:HEARTS AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:360-536-5432
Mailing Address - Street 1:418 E LAKESIDE AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2805
Mailing Address - Country:US
Mailing Address - Phone:208-600-0760
Mailing Address - Fax:
Practice Address - Street 1:418 E LAKESIDE AVE STE 6
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2805
Practice Address - Country:US
Practice Address - Phone:208-600-0760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care